A Crash Course on Bipolar Disorder

May 13, 2015 &middot by Jessica Hewitt

Because I’m vocal about my diagnosis of Bipolar Disorder, I am often contacted for information by people who are affected by the condition, either personally or through a family member or friend. To quickly bring someone up to speed, I wrote a short reference guide on the illness, so I thought I would share it here, as well.

Summary Information on Bipolar Disorder
Bipolar disorder, also known as manic-depressive illness, is a brain disorder that causes unusual shifts in mood, energy, activity levels, and the ability to carry out day-to-day tasks. Symptoms of bipolar disorder are severe. They are different from the normal ups and downs that everyone goes through from time to time. Bipolar disorder symptoms can result in damaged relationships, poor job or school performance, and even suicide. But bipolar disorder can be treated, and people with this illness can lead full and productive lives.

Who is Affected by Bipolar Disorder?

Bipolar disorder affects approximately 5.7 million adult Americans, or about 2.6% of the U.S. population age 18 and older every year. (National Institute of Mental Health)

The median age of onset for bipolar disorder is 25 years (National Institute of Mental Health), although the illness can start in early childhood or as late as the 40’s and 50’s.

An equal number of men and women develop bipolar illness and it is found in all ages, races, ethnic groups and social classes.

Bipolar disorder results in 9.2 years reduction in expected life span, and as many as 1 in 5 patients with bipolar disorder completes suicide. (National Institute of Mental Health)

Causes

Most scientists agree that there is no single cause of bipolar disorder. Rather, many factors likely act together to produce the illness or increase risk, including genetics and brain structure and functioning.

Signs & Symptoms

People with bipolar disorder experience unusually intense emotional states that occur in distinct periods called “mood episodes.” Each mood episode represents a drastic change from a person’s usual mood and behavior. An overly joyful or overexcited state is called a manic episode, and an extremely sad or hopeless state is called a depressive episode. Sometimes, a mood episode includes symptoms of both mania and depression. This is called a mixed state. People with bipolar disorder also may be explosive and irritable during a mood episode.

Extreme changes in energy, activity, sleep, and behavior go along with these changes in mood. Symptoms of bipolar disorder are described below.

Manic Episode Mood Changes

A long period of feeling “high,” or an overly happy or outgoing mood

Extreme irritability

Manic Episode Behavioral Changes

Talking very fast, jumping from one idea to another, having racing thoughts

Being easily distracted

Increasing activities, such as taking on new projects

Being overly restless

Sleeping little or not being tired

Physical Aggression

Hypersexualtity

Having an unrealistic belief in one’s abilities and an inflated self-esteem

Behaving impulsively and engaging in pleasurable, high-risk behaviors

Depressive Mood Changes

An overly long period of feeling sad or hopeless

Loss of interest in activities once enjoyed, including sex.

Depressive Behavioral Changes

Feeling tired or “slowed down”

Having problems concentrating, remembering, and making decisions

Being restless or irritable

Changing eating, sleeping, or other habits

Isolating from family and friends

Thinking of running away, death or suicide, or attempting suicide

Sometimes, a person with severe episodes of mania or depression has psychotic symptoms too, such as hallucinations or delusions. The psychotic symptoms tend to reflect the person’s extreme mood. For example, if you are having psychotic symptoms during a manic episode, you may believe you are a famous person, have a lot of money, or have special powers. If you are having psychotic symptoms during a depressive episode, you may believe you are ruined and penniless, or you have committed a crime. As a result, people with bipolar disorder who have psychotic symptoms are sometimes misdiagnosed with schizophrenia.

Bipolar disorder usually lasts a lifetime. Episodes of mania and depression typically come back over time. Between episodes, many people with bipolar disorder are free of symptoms, but some people may have lingering symptoms.

Diagnosis
Doctors diagnose bipolar disorder using guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM). To be diagnosed with bipolar disorder, the symptoms must be a major change from your normal mood or behavior.

There are four basic types of bipolar disorder:

Bipolar I Disorder — defined by manic or mixed episodes that last at least seven days, or by manic symptoms that are so severe that the person needs immediate hospital care. Usually, depressive episodes occur as well, typically lasting at least 2 weeks.

Bipolar II Disorder — defined by a pattern of depressive episodes and hypomanic episodes, but no full-blown manic or mixed episodes.

When getting a diagnosis, a doctor or health care provider should conduct a physical examination, an interview, and lab tests. Currently, bipolar disorder cannot be identified through a blood test, but these tests can help rule out other factors that may contribute to mood problems, such as a stroke, brain tumor, or thyroid condition. If the problems are not caused by other illnesses, your health care provider may conduct a mental health evaluation or provide a referral to a trained mental health professional, such as a psychiatrist, who is experienced in diagnosing and treating bipolar disorder.

Bipolar disorder can worsen if left undiagnosed and untreated. Episodes may become more frequent or more severe over time without treatment. Also, delays in getting the correct diagnosis and treatment can contribute to personal, social, and work-related problems. Proper diagnosis and treatment help people with bipolar disorder lead healthy and productive lives. In most cases, treatment can help reduce the frequency and severity of episodes.

TreatmentsBipolar disorder cannot be cured, but it can be treated effectively over the long-term. Proper treatment helps many people with bipolar disorder—even those with the most severe forms of the illness—gain better control of their mood swings and related symptoms. But because it is a lifelong illness, long-term, continuous treatment is needed to control symptoms. However, even with proper treatment, mood changes can occur.

A support system is absolutely imperative for recovery from life disrupting symptoms.

Medication
Medication is necessary to treat bipolar disorder, and there are different types used to help control symptoms of bipolar disorder. Not everyone responds to medications in the same way. You may need to try several different medications before finding ones that work best for you.

The types of medications generally used to treat bipolar disorder include mood stabilizers, atypical antipsychotics, and antidepressants.

If someone who does not have bipolar takes these medications, their behavior will not be altered. They will just experience the myriad of side effects.

Psychotherapy
When used in combination with medication, psychotherapy can be an effective treatment for bipolar disorder. It can provide support, education, and guidance to people with bipolar disorder and their families. Some psychotherapy treatments used to treat bipolar disorder include:

Cognitive behavioral therapy (CBT), which helps people with bipolar disorder learn to change harmful or negative thought patterns and behaviors.

Family-focused therapy, which involves family members. It helps enhance family coping strategies, such as recognizing new episodes early and helping their loved one. This therapy also improves communication among family members, as well as problem-solving.

PsychoeducationThis teaches people with bipolar disorder about the illness and its treatment. Psychoeducation helps an individual to recognize signs of an impending mood swing so she can seek treatment early, before a full-blown episode occurs. Usually done in a group, psychoeducation is also helpful for family members and caregivers.